Healthcare Provider Details

I. General information

NPI: 1306830443
Provider Name (Legal Business Name): LISA M. KRALIAN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2005
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 W MAIN ST
WESTBOROUGH MA
01581-1902
US

IV. Provider business mailing address

16 LELAND ST
GRAFTON MA
01519-1414
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-8534
  • Fax:
Mailing address:
  • Phone: 508-839-4283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3201 TP
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: